Comparative Analysis Of The Diagnostic Value Of Small Bowel Fistula Between Conventional Enteroclysis And Abdominal Computed Tomography

Objective: To investigate the value of conventional enteroclysis and abdominal computed tomography(CT)in the diagnosis of small bowel fistula.Methods: In this retrospective study,clinical data of inpatients who underwent both conventional enteroclysis and abdominal CT for suspected small bowel fistula in Xuzhou Central Hospital from January 2012 to December 2021,and to compare and analyze the difference between the two examination methods in the diagnostic accuracy of small bowel fistula.Results:⑴Of the 46 small bowel fistula patients,26 were male and 20 were female;the median age was 61 years(range 15-77).Among the diseases causing small bowel fistula,the aetiology was benign disease in 15 cases(32.6%)and malignant disease in31 cases(67.4%).Of the 28 cases(60.9%)with iatrogenic fistula,26 cases(56.5%)were surgical complications,2 cases(4.3%)were radiological intestinal injury.Intra-abdominal fistula were 27 cases(58.6%),enterocutaneous fistula were 19cases(41.3%).⑵Diagnostic imaging:Of the 46 patients,35 cases were diagnosed by conventional enteroclysis and 16 by abdominal CT.The positive rates of conventional enteroclysis and abdominal CT for the diagnosis of small bowel fistula were 76.1% and 34.8%,respectively.The difference between conventional enteroclysis and abdominal CT was statistically significant(χ2=8.7568,P<0.05);There were 7 cases with positive diagnosis on both conventional enteroclysis and abdominal CT;28 cases with positive diagnosis on conventional enteroclysis and negative diagnosis on abdominal CT;9cases with negative diagnosis on conventional enteroclysis and positive diagnosis on abdominal CT;Conventional enteroclysis combined with abdominal CT was used to diagnose 44 positive cases of small bowel fistula,with a positivity rate of 95.7%;2cases(4.3%)with negative diagnosis on both conventional enteroclysis and abdominal CT.Positive rate of small bowel fistula diagnosed by conventional enteroclysis combined with abdominal CT is higher than either conventional enteroclysis alone or abdominal CT alone⑶Of the 46 patients,24(52.2%)had combined intestinal obstruction and 35(76.1%)had symptoms of digestive fluid leakage.After infusion of meglumine diatrizoate via the nasojejunal tube,symptoms of intestinal obstruction were relieved in 15 patients and symptoms of digestive fluid leakage in 24.⑷Treatment: Of the 46 patients,12 died,with a mortality rate of 26.1%;24 patientswere treated conservatively only,17 improved and 7 died;22 patients were treated surgically,17 improved and 5 died.Conclusion:(1)The rate of positive small bowel fistula diagnosis by conventional enteroclysis is higher than that by abdominal CT.⑵Conventional enteroclysis combined with abdominal CT can improve the detection rate of small bowel fistulas.